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NPI Code Detail

MEDICARE: SYRACUSE ENT SURGEONS PLLC

MEDICARE: SYRACUSE ENT SURGEONS PLLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Y00000XOtolaryngology Physician

General Provider Information

NPI Number : 1912941212
Entity Type Code : Organization
Provider Name (Legal Business Name) : SYRACUSE ENT SURGEONS PLLC
Provider Business Mailing Address
First Line : 3906 E GENESEE STREET
Second Line :
City : DEWITT
State : NY
Zip : 13214-1934
Country : US
Telephone Number : 315-251-1093
Fax Number : 315-251-1571
Provider Business Practice Location Address
First Line : 3906 E GENESEE STREET
Second Line :
City : DEWITT
State : NY
Zip : 13214-1934
Country : US
Telephone Number : 315-251-1093
Fax Number : 315-251-1093
Authorized Official
Title or Position : PRESIDENT
Name : PATRICK J CHILES
Credential : MD
Telephone Number : 315-251-1093
Provider Enumeration Date : 06/16/2006
Last Update Date : 04/23/2008

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Directions to “SYRACUSE ENT SURGEONS PLLC ” Practice Location

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